fester

This one probably only applies to T1's on lantus ..... so here goes.

I've upped my lantus from 26 to 28 units a day taken at 6.00pm. Now on the
face of it it's a fairly minor adjustment however it seems to have had a
pretty major effect. Where 2 hour pp's were between 5 and 6 mmol/l they are
now between high 3 and low 4's although they do seem to be dropping a little
too much and taking me down into hypoish areas. This in itself is not a
problem for me, what i think i now need to do is reduce my intake of
novorapid with breakfast and lunch so that only one of my insulins is
lowering bg's not both of them.

I just find it hard to believe that a mere 2u increase can have this much
effect. However the results speak for themselves as i've not seen a blood
test over about 7 mmol/l in the last 2 days. What i would like to do is
stop my bloody sugar going any lower than 4 in between meals without having
to take on board little snacks. If this is just not possible when micro
managing diabetes as a T1 i'll STFU and enjoy the lower numbers and just
make sure i test as often as i have been and adjust by food or insulin dose
as required.

As a rule what are your opinions on where blood sugar should be? Is it
better to be as low as you can even if that means a few adjustments, or are
we trying to aim for a system that runs automatically between meals? I have
felt the benefit of "Normal" blood sugar levels and am anxious to retain
them and to be honest i don't much care if i have to test 15 times a day,
inject 9 times a day and snack 2 times a day between meals to get them.

My current daily "routine" is as follows;

07:00 breakfast is two weetabix, semi skimmed milk with 8u ( FBG this
morning was 4.6)

09:00 Test and eat / inject as required ( today i was 5.2)

10:30 tested and adjust ( toda was 3.6 mmol/l so had a cookie and a coffee
with half a sugar in it.)

12:00pm Dinner which is now only one chicken or turkey salad wholegrain
breadcake, no crips OR sausage rolls taken with 10u of novorapid ( has given
me 2hr pp of 6.1 and 6.3 the last two days

2:00pm Test and adjust.

5:00pm Test and adjust before driving home at 5.30pm.

6 to 7 pm Tea. Whatever i eat is now no more than 40g of carb with 8 to 10u
of novorapid

9:00pm test and adjust again.

11:00pm One slice of burgen / soya toast with a small glass of milk ( done
this the last two days and my fbg has been spot on.)

So all this being the case, it seems that i'm getting much better control
largely due i think to starting the day off at a decent blood sugar level.
My sole remaining question is about the basal ammount. I still can't get my
head around 2 units making THAT much difference!

Your comments positive or otherwise are always welcomed. I won't be around
for the next 3 or 4 days as the caravan season is open and my mates static
caravan is open for bar - b - q's again See you all on monday sometime i
think.

Cheers.

Patrick


--
Type 1 Diabetic. Dx'd 1993.
On 28u Lantus and whatever Novorapid my meter says i need.

louise

Hi,

I too noticed a big difference when I upped my dose by just two units. From
morning readings of high 6's, low 7's to low 4's occasional high 3's. I was
shocked infact. Nice to see someone else has noticed similar results!

Also noticed a different to my 1hr and 2hr pp's, in fact I have had to
adjust my novorapid doses slightly - upping food wasn't my preferred option
as i'm trying to loose a few pounds.

The lantus seems to be suiting me much better than the insulatard!

Lou


are

little

having

dose

al hardy

3.8 is about the lowest you ever want to go, but of course it depends how
accurate yor meter is.

Oh it certainly can, especially as you get nearer and nearer to the right doseage for *you*.


Oh yes it is possible, but that does not mean it is easy.


Please don't do that!


Not as low as you can, that means 2s all the time. There is a *range* you
aim at, on my meter 3.7 to 6.6, but I know my meter reads lower than it
should. Accurate 4.0 to 7.0 if you can get the meter calibrated is a good
target range. I like to be in high 3s or low 4s before a meal, and high 5s
after a meal doesn't worry me, but that is me for me, and I don't recommend
or not recommend for others. You asked for an opinion, that's what I give.


Yes, we do try for that, it's what basal is for.

Several do that, but I don't.

I wonder if you are getting into the habit of *eat and shoot to cover it*?
Semi-skimmed milk has more carb, volume for volume, than unskimmed milk,
because the fat is skimmed off, not the carb.


It just does, see above comments.

Enjoy your bbq and caravanning, m8.

Al.

fester

Seems to be accurate enough ... well i tested it against my medisense
preciision and they agreed results.

That sweet spot thing .....

I was speaking metaphorically ... i never know when to end a conversation on
here, i just tend to ramble around till i find what it is i was meaning to say.


I meant by as low as i can, as close as i can get to 4's and 5's.


No .. you have a much tighter handle on your diet ... i know that from what
you post in here.


I was doing that a little bit until a week or so ago, i've had *better*
control .. now i know how to get good control that's the difference.

Well so be it then

Oh i will ... hope to see you all early next week rested and refreshed, a
very happy easter to you all.

Patrick

fester

I agree entirely about the insulatard, i wish i'd found basal / bolus ten
years ago! Glad someone else has found what i'm finding, its nice to find
that in this strange world of YMMV that someone else is getting the same
mileage as you are

Thanks for that and enjoy your easter break.

Patrick.

ian harding

The holy grail! (well, another step on the path)

Possible, but time-consuming and hard work. My basal regime allows my
BG to sit at a more or less constant level throughout the day apart from
the post-meal peaks (which I shoot bolus for). I estimate it took 3-4
months of effort from starting to use beef lente to achieving this, the
best technique is to miss one meal in the day, and the associated bolus,
and keep testing every hour or two until the next one.

The only exceptions to this state of affairs are when I've had a
"maximum effort" session on the weights at the gym at lunchtime then
about 5pm my BG drops like a stone by about 4mmol/l - but it's fairly
predictable and I have some fruit ready to deal with it.


I was adjusting my beef lente by 1u every few days at one point and
getting noticeable and repeatable differences in BG as a result.

Have a good weekend. I'm off to the Isle of Wight to see mum and dad
(and fix mum's computer, and install a new satellite receiver, and ... ;-)

--
Ian Harding
Dx T1 Jan '02. MDI Humalog and 2x Hypurin Bovine Lente